2003-2010年临床分离病原菌的分布及变迁

目的 探讨医院感染病原菌分布及变迁.方法 采用VITEK-2 Compact全自动微生物分析仪及配套试剂进行菌种鉴定及药敏试验,应用WHONET5.4软件完成统计分析.结果 医院2003-2010年共分离出病原菌6684株,革兰阴性菌、革兰阳性菌、真菌分别占60.5％、20.9％、18.6％；医院感染的高发部位为下呼吸道；8年间病原菌总排名前7位分别是铜绿假单胞菌、真菌、不动杆菌属、金黄色葡萄球菌、大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌；糖非发酵菌是医院感染的重要病原菌,其在总病原菌的构成比例及种类均呈上升趋势；金黄色葡萄球菌主要来源于痰标本,占70.82％,而凝固酶阴性葡萄球菌主要来源于生殖道、血液、痰,分别占27.85％、24.48％、24.24％；医院侵袭性真菌感染仍以白色假丝酵母菌为主,非白色假丝酵母菌所占比例呈逐年升高趋势.结论 医院感染病原菌以革兰阴性菌为主,高发部位为下呼吸道,条件致病菌(非发酵菌、真菌)成为主要病原菌,应加强监测,预防暴发流行.

Distribution and variation of pathogenic bacteria isolated from clinical specimens during 2003-2010

OBJECTIVE To observe distribution and variation of the pathogens causing nosocomial infections.METHODS The identification and the drug susceptibility testing of the isolated bacteria were performed by the VITEK2 Compact system.A retrospective analysis was performed to the bacterial culture results with WHONET 5.4 software.RESULTS Of 6684 isolated pathogens,60.5% were gram-negative bacteria,20.9% were gram-positive bacteria,and 18.6%were fungi;respiratory tract was the high site for nosocomial infection;the top 7 pathogens isolated during the past 8 years were Pseudomonas aeruginosa,fungi,Acinetobacter baumannii,Staphylococcus aureus,Escherichia coli,coagulase-negative Staphylococci,and Klebsiella pneumoniae;non-fermenting bacteria were the majority of the pathogens causing nosocomial infections,both their constitution ratio and species proportion showed an upward tendency;S.aureus were mostly isolated from sputum(70.82%),coagulase-negative Staphylococci were mostly isolated from reproductive tract(27.85%),blood(24.48%),and sputum(24.24%),respectively;Candida albicans remained the main pathogen causing invasive fungal infections,the proportion of non-C.albicans strains increased year by year.CONCLUSION Gram-negative bacteria are dominant pathogens causing nosocomial infections,the infections occur frequently in the lower respiratory tract,opportunistic pathogens including non-fermenting bacteria and fungi have become the main pathogens,so the hospital should strengthen the monitoring to prevent the outbreaks and prevalence of nosocomial infections.